integrated approach of yoga therapy towards morbid obesity

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www.jimcr.com INTEGRATIVE MEDICINE CASE REPORTS VOLUME 1 NUMBER 1 JANUARY 2020

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*Corresponding Author:

Reshma P. Jogdand, MDSVYASA University, Bangalore.Contact no: +91-9449164937E-mail: [email protected]

Integrated approach of yoga therapy towards morbid obesity: A case report

Reshma P. Jogdand*, Amit Singh, Raghuram Nagratna

The Department of Life sciences, SVYASA University, Bangalore

ABSTRACT

The present case study is of evaluation of Grade 3 obesity who visited the Arogyadhama (SVYASA University, Bangalore). Conversations with the patient uncovered that the patient was being treated for obesity and patient portrayed his capacity to deal with the mental pressure related with overweight. He credited it to the inspirational demeanor created by his Yoga practice for 48 days. The patient was additionally ready to decrease body weight. The present narrative is an endeavor to give IAYT Practices, detoxification through Naturopathy.

doi: 10.38205/imcr.010139

KEY WORDS

Obesity grade 3Yoga therapyNaturopathyLifestyle

IntroductionOverweight and obesity are characterized as unreasonable fat accumulation that is hazardous to wellbeing. An unrefined proportion of obesity is the weight record of BMI, an individ-ual’s weight (in kilograms) separated by the square of their stature (in meters). An individual with a BMI of at least 30 is commonly viewed as Obesity grade 3. An individual with a BMI equivalent to or more than 25 is regarded as overweight.

Overweight and obesity are significant risk factors for various disorders, including diabetes, cardiovascular ailments and malignant growth (1).

Yoga reasoning and practice was first codefied by Patanjali to the great content, Yoga Sutras are broadly recognized as the legitimate content on Yoga. Yoga is a type of mind-body wellness that includes a blend of strong action and a coordinated atten-tion to oneself, the breath, and vitality. Yoga is perceived as a type of mind-body practice that coordinates a person’s physical, mental and profound segments to improve parts of wellbeing, especially stress related ailments (2).

In 2016, more than 1.9 billion grown-ups matured to 18 years while the more seasoned were found to overweight. Of these more than 650 million grown-ups were large. In 2016, 39% of grown-ups matured 18 years and over (39% of male and 40% of female) were overweight. Overall, about 13% of the world’s grown-up population (11% of male and 15% of female) were fat in 2016. The overall predominance of heftiness almost significantly increased somewhere in the range of 1975 and 2016.

In 2016, an expected 41 million kids younger than 5 years were overweight or fat. Overweight and heftiness are presently on the increase in low-and middle income nations, especially in urban settings. In Africa, the degree of over-weight youth, under 5, has expanded by almost 50 percent since 2000. More than 340 million kids and young people ma-tured to 5–19 were overweight or in 2016.

The predominance of overweight and weight among youngsters and teenagers matured in the age group of 5–19 has risen drastically from only 4% in 1975 to simply over 18% in 2016. The increase has happened comparably among the two young men and young ladies: in 2016, 18% of young ladies and 19% of young men were overweight. While un-der 1% of children and adolescents aged 5–19 were obese in 1975, more than 124 million children and adolescents (6% of girls and 8% of boys) were reported obese in 2016.

Overweight and obesity are known to be the primary contributing factors for deaths worldwide than underweight. Globally, there are more people who are obese than under-weight – this occurs worldwide except parts of sub-Saharan Africa and Asia (3).

The etiology of obesity is unquestionably more unpre-dictable than just an uneveness between vitality admission and vitality yield. In spite of the fact that this view permits simple conceptualization of the different instruments engaged with the advancement of obesity, factor is undeniably more than just the consequence of eating excessively as well as practicing pret-ty much nothing (sedentary lifestyle). Potential factors in the advancement of obesity are the following:

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• Metabolic factors• Genetic factors• Level of activity• Endocrine factors• Race, sex, and age factors• Ethnic and cultural factors• Socioeconomic status• Dietary habits• Smoking cessation• Pregnancy and menopause• Psychological factors• History of gestational diabetes• Lactation history in mothers

Developing information suggests that a striking incendiary, and potentially infective, etiology may exist for obesity. Fat tissue is known to be a vault of different cytokines, particu-larly interleukin 6 and tumor putrefaction factor alpha. One investigation indicated a relationship among obesity and a high-typical degree of plasma procalcitonin, a needy variable that mirrors a condition of pain or irritation. Data has demon-strated that adenovirus-36 is related with obesity in chick-ens and mice. In human examinations, the pervasiveness of adenovirus-36 disease is 20–30% in individuals who are obese, versus 5% in individuals who are not over weight (4).

Case presentationRecruitment of patientA 28 year old male participant from New Delhi, enrolled him-self at Prashanthi Kutiram on the 15th of June 2018 and was

put in section ‘H’, which deals with Obesity. He resided in cam-pus from 15.06.2018 to 02.08.2018 (48 days). He underwent Yoga therapy with some detoxification treatments like sauna

S. No. Loosening practice

Duration of procedure

Frequency Duration of intervention

1 Butterfly 10 2 times a day 8 weeks

2 Loosening of Fingers & wrist

10 2 times a day 8 weeks

3 Padasancalana 10 2 times a day 8 weeks

4 Loosening of elbow 10 2 times a day 8 weeks

5 Side bending 10 2 times a day 8 weeks

6 Shoulder Rotation 10 2 times a day 8 weeks

7 Twisting 10 2 times a day 8 weeks

8 Spinal Twisting 10 2 times a day 8 weeks

9 Neck movement 10 2 times a day 8 weeks

10 Rotation 10 2 times a day 8 weeks

11 Ardhakati Chakrasana


12 Sideward bending 10 2 times a day 8 weeks

13 Spinal twist 10 2 times a day 8 weeks

14 Hip stretch 10 2 times a day 8 weeks

15 Back stretch with alternate leg


16 Full butterfly 10 2 times a day 8 weeks

17 Alternate & both leg raising


18 Side leg raising 10 2 times a day 8 weeks

19 Cycling 10 2 times a day 8 weeks

20 Pavanamuktasana-kriya


21 Lumber stretch 10 2 times a day 8 weeks

bath, steambath, hip bath and underwater massage as well as for more relaxation and aids more benefits Mud pack to abdo-men and eyes for a week in between.

IAYT protocol: Treatment regimen

Loosening practice (5), (6)

Suryanamaskara (7)

S. No. Suryanamaskara Duration of procedure


1 HastauttanasanaPádahastásanaAswasancalanasanaTulasanaSasankasanaSastanganamaskarBhujangasanaParvatasanaSasankasanaAswasancalanasanaPádahastásanaHastauttanasana

12 24 times a day

8 weeks

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Pranayama (8) (9)

S. No. Pranayama Duration of procedure


1. NadishuddhiPranayama: Nādiśuddhi pran-ayama balances both the lobes equally which restores the bal-ance between the sympathetic and parasympathetic nervous system.

9 Rounds for each nostril

2 times a day

8 weeks

2. Brahmari:Brah-mari gives sooth-ing effect to the entire brain.

9 Rounds 2 times a day

8 weeks

3 Naadaanusandh-na: Breathing exercises, sec-tional breathing strengthens and soothes the entire nervous system restoring balance to a depleted and imbalanced au-tonomic nervous system

5 Rounds 2 times a day

8 weeks

Mind Sound Resonance Technique (MSRT) (10)

Advanced Yoga technique MSRT which is developed by SVYA-SA to specifically strengthen the immune defence, to develop will power and there by promote health and happiness was done once a day.

Deep Relaxation Technique (DRT) (11)

Each session of passive exercise, pranayama was completed with DRT.

DRT is a deeper and more intense form of relaxation. The entire body and the mind move together, connecting with each other while the breathing plays a crucial role to bring this connection. The main features of this form of relaxation technique are:

DRT is done in Savasana (Corpse Pose) and is best done at the end of the Yoga practice to release all the tensions while retaining the muscle strength. It is done longer and is gener-ally for a minimum of 15 minutes. It is always done with the instructions given by a Yoga teacher. DRT can also be done anytime during the day provided the time gap between meals is minimum 2+hours. It can also be done by anyone even with-out the practice of Yoga poses.

DRT is considered a base pose as deep relaxation tech-nique variations can be derived from this pose.

Breathing practices

S. No Breathing practices

Duration of procedure


1 Hand Stretch Breathing

2 minutes 2 times a day

8 weeks

2 Hands In and Out Breathing


8 weeks

3 Ankle stretch Breathing


8 weeks

4 Tiger Breathing


8 weeks

Yogasana (12)

S. No. Yogasanas Duration of procedure


Standing position

1. Ardhakati Chakraas-ana: Reduces fat in waist region, stimulates the sides of the body. Give lateral bending to the spine.


8 weeks

2. Ardha Chakraasana: Makes the spine flexible, stimulates the spinal nerves, promotes circulation of blood into head. Strengthens the neck muscles. Expands chest and shoulders. Improves breathing.


8 weeks

Sitting position

3. Vakrasana: Lateral twist gives flexibility to the spine, tones up the spinal nerves. Helps to cure constipation. Improves lung capacity.


8 weeks

Prone position

4. Bhujangasana: Brings flexibility to the dorsal spine. Strengthens the spinal muscles. Reduces the abdominal fat.


8 weeks

Shalabhasana: Helpful in managing sciatica and low back ache. Reduces fat on thighs and buttocks.


8 weeks

(Continued)

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Supine positionSethubandhasana: The extensor muscles of the back grow powerful and the hips are con-tracted and hardened. The asana strengthens the neck and tones the cervical, dorsal, lumbar and sacral regions of the spine.


8 weeks Diet ProtocolParticipant completely underwent a Naturopathic diet in-cludes raw diet (fruits, Salad, Sprouts and buttermilk), Boiled diet (Boiled vegtables, Chapati, Rice, Dal and Butermilk) as well as planed frequent juice therapy and fruit diet and also underwent a Naturopathy treatment for detoxification for a week in starting (6 days).

Naturopathy diet:8:00 am 10:00 am 12:00 pm 2:00 pm 5:00 pm 7:30 pm 8:30 pm

1st day Juice Juice Boiled diet Juice Juice Boiled diet Kashayam

2nd day juice juice Raw diet juice juice Raw diet Kashayam

3rd day Juice Juice Juice Juice Juice Juice Juice

4th–6th day Lemon honey juice fasting

7th day juice juice Raw diet juice juice Raw diet Kashayam




15th day juice juice 1 apple juice juice 1 apple Kashayam

16th–22nd day Lemon honey juice fasting

23rd day juice juice 1 apple juice juice 1 apple Kashayam




31st–32nd day juice juice 1 apple juice juice 1 apple Kashayam

33rd day juice juice Raw diet juice juice Raw diet Kashayam

34th day juice juice Boiled diet juice juice Boiled diet Kashayam



37th day–44th day Lemon honey juice fasting




48th day juice juice Boiled diet juice juice Boiled diet Kashayam

8:00 am 10:00 am 12:00 pm 2:00 pm 5:00 pm 7:30 pm 8:30 pm

Saturday Ashguard juice Bitterguard juice Lunch Lemon honey juice Papaya juice Dinner Kashayam

Sunday Carrot juice Watermelon Lunch Lemon honey Musk melon Juice

Dinner Kashayam

Monday Bottleguard juice Musk melon Lunch Buttermilk PapayaJuice

Dinner Kashayam

Tuesday Methi water PinappleJuice

Lunch Lemon honey Carrot juice Dinner Kashayam

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Wedensday Ash guard juice Carrot juice Lunch Lemon honey Papaya juice Dinner Kashayam

Thursady Carrot juice Ash guard Lunch Buttermilk Dinner Kashayam

Friday Breakfast – Pongal+buttermilk

– – Dinner –

8:00 am 2:00 pmSaturday Mud pack to abdomen and eye Full mud bath

Sunday – Cold under water massage

Monday Mud pack to abdomen and eye Full body massage

Tuesday – Vibromsg to abdomen and thigs+sauna bathWednesday Mud pack to abdomen and eye Cold hip bath+GH Pack

Thursday Mud pack to abdomen and eye Sauna bath+Vibromsg to abdomen

DiagnosisProgression of Obesity was detected by his Anthropometric measurements, whose reports were provided by the patient.

Lunch (boiled diet) 1 chapati, 1 cup adl, 1 cup rice, buttermilk, 100gm boiledvegtables (beans+pumkine+beatroot+methi+spinach+knolkhol)Dinner: (raw diet) 2-3 slices fruits(papaya+watermelon+pomegranate/muskmelon), Vegetable salad (cucumber+pomegranate+beatroot+ carrot), sprouts (Moong+groundnuts), ButtermilkNaturoapthy Treatment chart (only for 1 week in a starting of protocol for detoxification)

Parameters DOA DOD Parameters DOA DODPulse Beats/min 86 bpm 70 bpm Weight in kg 142 kg 121.6 kgBP in mmHg 150/100 mm/Hg 130/90 mm/Hg Height in mt 172 cm ***Respiratory Cycles/min 16 cpm 16 cpm BMI [Kg/mt2] 47.99 42.2Bhramari Time (Sec) 9 sec 9 sec Mid arm circumference 42 cm 37 cmSymptoms score 0 0 Waist circumference 144 cm 136 cmMedication score 0 0 Hip circumference 136 cm 129 cm

Vital data and Anthropometric measurements:

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The patient was able to lose 20.4 Kgs of weight after following the above treatment regimen as well as regulation of Pulse rate and respiratory rate take place. Blood pressure got marked in range that is 130/90 mm/hg compare to before treatment. Respiratory rate remain regular and same after the treatment. There will be drastic reduction in weight and anthropometric measurements that includes mid arm cir-cumference from 42 cm to 37 cm, Hip circumference 136 cm to 129 cm and Waist circumference from 144 cm to 136 cm as well as marked reduction in overall Body mass index from 47.99-42.2 Kg/(M)2.

DiscussionThe weight of patients has been accounted to increase since a long time. Aggravating factor is the absence of physical move-ment and life style. Anthropometric parameters have indicat-ed that a patient belongs to grade 3 obesity. It is anticipated that the patient had the option to keep up a consistent body weight by receiving IAYT (Integrated methodology of Yoga treatment) which may have forestalled weight gain. During his stay, he experienced Integrated approach of Yoga treatment just as Naturopathy for Detoxification and Diet treatment moreover. Naturopathy helps to keep up balance between medicines and diet. Naturopathy enables improvement in fat digestion just as perspiration by follow up on waste frame-work. Patient used to practice Pranamyama (daily once), Yoga special technique day by day two sessions, (Weight decrease) just as Kriya (weekly twice). Overall, Yoga helped him to keep up physical wellbeing just as emotional well-being.

ConclusionA case of a 28 year old male of Grade 3 Obesity was conser-vatively managed using principles of Yoga therapy with Natu-ropathy as proposed by the SVYASA. By following the Obesity based protocol, the patient was successful to lose 20.4 Kgs and attain the desirable target set at the beginning of the month. It is, therefore, proposed that further prospective studies be car-ried out using Yoga therapy so that an evidence-based model of obesity protocol can be formulated for all patients in this age group.

AcknowledgementsWe would like to acknowledge the following people who played an instrumental role in the completion of this project. We grateful to Dr. Nagarathna and Dr. Amit Singh of research for sharing their thoughts with other people. We Would also like to thank Mr. Sumit Aundhekar for extending his support throughout our work.

Authorship contribution RPJ: has written article.RN: guided to write articleAS: has contributed in a treatment planning.

Informed consent formYes

Source of fundingNil

Conflict of interestNil

Received Date: 01-11-19; Revised Date: 11-02-20; Accepted Date: 13-02-20

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integrated approach of yoga therapy towards morbid obesity

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